Surgical brace



July 2, 1963 l. DAVIDSON ETAL SURGICAL ,BRACE Filed Aug. 28, 1961 IllINVENTOR5 EUGENE AJJE'WETT mym 2 Sheets-Sheet 1 y 1963 l. DAVIDSON ETAL3,095,875

SURGICAL BRACE Filed 1961 2 Sheets-Sheet 2 INVENTORS EUGENE 4.. \JEwEz-rATTORNEYS 3,ee ,8?5 Patented July 2., 1963 ice 3,995,875 SURGHCAL BRACEIan Davidson, Toronto, Ontario, Canada, and Eugene L.

Jewett, Maitland, Fla, assignors to Florida Brace Corporation, WinterPark, Fla., a corporation of Florida Filed Aug. 28, 1961, Ser. No.134,426 8 Claims. (Cl. 123-78) This invention relates to a surgicalbrace.

The brace embodying the invention has a lower portion which can befitted with accuracy to encircle the pelvic region of a patients body toprovide a firm support with respect to which the upper portion of thebrace is accurately adjustable to maintain the thoracic-lumbar spine andlumbosacral area immobilized against undesirable backward movement orextension while keeping the spine in varying degrees of forward bendingor flexion. A brace of this character has been found to be particularlydesirable in numerous conditions such as inter-vertebral disk rupture,facet malalignment, pathological conditions, soft tissue disability, andother conditions affecting the lumbar spine and lumbosacral area. It isalso useful following certain operative procedures in this region.

The brace as hereinafter disclosed provides excellent pelvic andlumbosacral stabilization and effectively anchors a girdle or basesection of the brace to the pelvis and sacrum, thereby providingpositive support, while giving fixedly adjustable control of thelumbosacral joint and nevertheless permitting substantially instantremoval and replacement without affecting the adjustments. In many ofthe conditions in which this brace is used, it is not only permissiblebut desirable that the patient have some freedom of forward movement orflexion but none in the backward or extension direction. The facility ofremoval or replacement of the brace by the patient is desirable.However, it is important that the adjustment made for medical orsurgical reasons shall not be altered by the patients removal orreplacement of the brace.

As will be pointed out more particularly hereinafter, anchorage to thepelvis and sacrum is achieved by pubic support bars which partiallyencircle the patients pelvis anteriorly and laterally and connect to apubic pad at the front, and to posterior or buttocks pads at the sidesand rear. These buttocks pads are connected to each other by anadjustable strap having a detachable anchorage at least at one of itsends, and completing the enclosure of the pelvic region. On the lowergirdle or pelvic section thus formed, upwardly extending frame arms aremounted which are disposed at the sides of the patients body and haveangularly adjustable connections with a forwardly open upper framesection. This upper frame section, which partially encircles the lowerthoracic spine anteriorly comprises lateral bars or side pads attachedto the upper frame arms, these being in pivotally adjustable connectionwith the frame arms of the lower section. By adjustable andnon-extensible straps the lateral or side components of the upper framesection support a thoracic lumbar pad which imposes any desiredlimitation on the backward bending or extension of the thoracic lumbarspine and the lumbosacral junction.

In the drawings:

FIG. 1 is a view in perspective of a complete surgical brace embodyingthe invention, including an apron attachment used therewith.

FIG. 2 is a front elevational view of the assembled frame sections ofthe surgical brace, without the apron.

FIG. 3 is a rear elevational view of the brace structure shown in FIG.2.

FIG. 4 is a side elevational view of the brace.

FIG. 5 is a View in front elevation of the apron.

FIG. 6 is an enlarged detail view taken in section on the line 66 ofFIG. 2.

FIG. 7 is an enlarged detail view of a preferred latch device taken insection on the line 7--7 of FIG. 4.

FIG. 8 is an enlarged detail view in perspective fragmentarilyillustrating separate parts of the lock joint between the lower andupper frames of the brace.

FIG. 9 is an enlarged detail view in section through separated anchorageparts used to connect the rear strap portion of the brace.

As already indicated, the brace is made in two sections, the lowersection being in the nature of a girdle anchored about the patientspelvis as securely as is possible consistent with freedom of bodilymovement, the lower section providing a secure basis for positivelyfixing the upper section in a position to maintain the thoracic lumbarspine against backward movement or extension beyond the desired angle.

The lower section of the brace completely encircles the pelvic region ofthe patient. At the front there is a pubic pad 10 connected withbuttocks pads 11 and 12 by pubic support bars 13, 14 which are curved toextend over the lower lateral abdominal or groin region and havedownwardly and inwardly curving forward end portions 15, 16 adjustablyconnected to the pubic pad 10.

The pubic pad 10 has an internal metal reinforcing plate 17 enclosed ina moisture and soilproof covering with any desired padding.

' The buttocks pads 11 and 12 are similarly made. From their connectionwith the bars 13 and 14, they extend downwardly and backwardly, beingrelieved at 18 to clear the lateral pelvic area of the wearer andextending thence backwardly and downwardly to substantially the level ofthe pubic pad 10. They are provided with hooklike fixtures at 19 and 20with which the eyes 21, 22 of the adjustable strap 23 are connected tocomplete the encirclement of the patients pelvic region.

Extending upwardly from the end portions 24 of the bars 13, 14 are rigidframe arms 25, 26, one of which is shown in detail in FIG. 8. At itsupper end, each such arm is provided with a coupling head 27 having aboltreceiving aperture at 28 and radial serrations or the like at 29complementary to a similar head and serrations of a frame bar of theupper section. In practice these serrations are five degrees apartwhereby the flexion is controllable with precision. In the upper sectionthe bars 30 and 32 have holes 280 threaded to receive the securing bolt31 which adjustably connects the coupling head 270 of each upper framebar to that of the respective lower frame bar, the serrations 290 of theupper bar mating with those of the lower bar to secure the upper framebar rigidly in any desired angular relationship to the lower frame atfive degrees intervals.

Obviously, a variety of other expedients may be used to provide thenecessary angular adjustment of pivotal connection between the upperframe section and the lower frame section of the brace. That disclosedis preferred because of its simplicity and compactness and the rigidityof the joints achieved when the desired adjustment is locked bytightening the screw 31 in the threaded opening at 280.

The bars 30 and 32 of the upper frame carry side pads 35 and 36respectively. The preferred cross sectional construction of these padsis shown in FIG. 6. Each comprises a fairly stifi but resilientlybendable sheet 37 which carries sponge rubber or similar padding at 38and is confined within outer and inner facing plies 39 and 40 ofsuitable soil and moisture resistant flexible material. The outer andinner facing plies 39 and 40 are stitched together at 41 through thepadding 38, such stitching serving to position an inner reinforcingplate at 42 in which the screws 43 connecting the lateral pad to theupright bar 30 or 32 are anchored. Thus only the forward portion of eachof the side pads 35' and 36 is made relatively rigid by the plate 42,the rearward sections 350 and 360 being relatively flexible, althoughstill? rather than limp.

The rearward sections 350 and 360 of the side pads 35 and 36 lap or meeta large thoracic lumbar pad 50 which includes within its outer coveringa somewhat still? but resiliently flexible sheet 51 having padding ofsponge rubber or the like 52 on its inner face. Stitched externally tothe covering 53 is a pocket ply 54 which anchors a stiff and relativelyunyieldable plate 55 and the flexible but unstretchable straps 56, 57and 58. At one side of the brace, usually on the wearers left, thestraps 56 and 57 are adjustably fixed to the upper frame by means of thescrews 43, strap 58 desirably being fixed to the arm 26 of the pelvicframe. It has been found quite important to. use three straps ratherthan two, to position the thoracic lumbar pad.

At the other side, usually at the Wearers right, an upwardly openbracket 60 is provided for each strap. One bracket is shown in detail inFIG. 6. The bracket has an overhanging hook at 61 and receivesdetachably a sleeve 62 which is adjustable along the strap by means of aWorm 63 rotatably journaled in the sleeve and meshing with teeth out inthe strap as disclosed in United States Patent 2,582,930 and otherpatents therein identified. A handle 64- is provided for rotation of theworm for adjustment purposes. The connection of the strap to the bracketis readily released and re-established by the patient. The actualadjustment ordinarily requires little or no alteration by the patient.

If no restraint whatever is to be imposed upon the forward movement ofthe patients upper body about the lumbosacral junction, the device asdisclosed is complete. In practice, however, it is ordinarily preferredto employ a supplemental apron such as that separately illustrated inFIG. and shown in position of use in FIG. 1. The apron 70 is providedwith internal rib reinforcement 71 to any desired extent. It has apocket at 72 in which the lower portion of the pubic pad is receivable.The upper portion of the apron is connected by straps and buckles 76,760 with the frame elements. This apron encircles the patients abdomen.It may be laced at 73 for adjustment. It is desirably made ofstretchable material to accommodate consider-able yielding underpressure of the patients body. Yet it cooperates with the other elementsof the lower frame to fix the lower frame securely to the patientspelvic region.

Also used optionally to assist in positioning the lower frame are theelastic straps 77, 78 which are detachably hooked either to the lowerframe bars 13 and 14 or the pubic pad and extend downwardly andrearwardly beneath the patients perineum and buttocks and attach to thebuttocks pad. These perinea-l straps will be relatively loose when thepatient is standing but the patient will sit upon them when he is seatedand they will then tighten to hold the lower frame from working up uponthe body of the patient.

While the bars 13, 14, 26, 27, 30, 32 are somewhat flexible they areresilient and nearly rigid. They will normally be made of Duralu-min orsteel alloy and will be "sufficiently rigid to withstand, withoutperceptible yieldunder bodily pressure but are quite resiliently stiif,so

We claim:

1. A surgical brace comprising a pelvic section and a thoracic-lumbarsection in pivotally adjustable connection, the pelvic sectioncomprising pad means and body encircling means for positively fixing theposition of the pad means on a patients body, and havingpintlesupporting frame means; the thoracic-lumbar section of the bracecomprising lateral frame means in pivotal connection with thepintle-supporting frame means of the pelvic section aforesaid, a lumbarpad, means for connecting said lumbar pad with said lateral frame means;pintle means for pivotally connecting said sections, and means forpositively fixing the lateral frame means of the thoracic-lumbar sectionof the brace in selected pivotal adjustment regarding thepintle-supporting frame means of the pelvic section thereof.

2. A surgical brace comprising a pelvic section and a thoracic-lumbarsection in pivotally adjustable connection, the pelvic sectioncomprising buttocks pads, a pubic pad, pubic supporting bars connectingthe pubic pad with the buttocks pads, and strap means for connecting thebuttocks pads with each other at the rear of the patients body; thethoracic-lumbar section comprising a lumbar pad, side pads, frame barsconnected with the side pads, and means for connecting the lumbar padwith the said frame bars; and means for providing a fixedly adjustablepivotal connection between the pelvic and the thoracic-lumbar sectionsaforesaid.

3. A surgical brace comprising a pubic pad, buttocks pads, pelvisencircling means including frame elements for connecting the pubic andbuttocks pads, a thoraciclumbar pad, side pads, means including framemembers for connecting respective side pads with the thoracic- -lu-mbarpad and with the frame elements aforesaid, said connecting meansincluding pintles pivotally connecting respective frame elements andrespective frame members, and means for positively fixing the angularposition of each frame member respecting the frame element with which itis in pivotal connection upon the respective pintle.

4. A surgical brace comprising the combinationwith a pelvic sectionincluding a pubic pad and buttocks pads and pelvis-girdling meansconnecting the pubic pad and buttocks pads and including lateral frameelements provided with pintle apertures and serrations; of athoraciclumbar section comprising 'a lumbar pad, frame bars connectedwith the lumbar pad and having apertured ends complementary to the frameelements aforesaid, and pintle bolts passing through respective bars andframe elements and constituting clamping means for pressure engagementof the clamping bars and elements to hold them in adjusted position ofpivotal movement upon the respective pintle bolts.

5. The combination set forth in claim 4 in which the bars of thethoracic-lumbar section have side pads, each of which has a reinforcedportion connected with :1 respective bar and a stiffened portionextending rearwardly therefrom and lapping the lumbar pad.

6. The combination set forth in claim 4 in further combination withapron means connected with the pubic pad and the respective bars of thethoracic-lumbar section and constituting a resiliently stretchable Webspanning the thoracic-lumbar section opposite said lumbar pad.

7. The combination set forth in claim 4 in which the bars and frameelements have complementary surfaces provided with radial ribs andserrations at pre-determined angular intervals whereby the adjustedposition fixed by said clamping means can be accurately pre-determined.

8. A surgical brace comprising pelvic and thoraciclumbar sections inpivotally adjustable connection, the said sections including lateralframe means, the pelvic section of the brace including buttocks pads, apubic pad and pelvic encircling means connecting said buttocks pads andpubic pad, said thoracic-lumbar section comprising a thoracic-lumbar padhaving upper, intermediate and lower non-extensible straps in adjustableconnection with the lateral frame means of the brace.

References Cited in the file of this patent UNITED STATES PATENTS 62,760,486 Ward Aug. 28, 1956 2,808,050 Ward Oct. 1, 1957 FOREIGN PATENTS931,975 Germany Aug. 22, 1955 OTHER REFERENCES A T hree-PointHyperextension Back Brace, Griswold, Journal of Bone and Joint Surgery,pages 784-786, July 1936, on file in Div. 55.

Journal of Bone and Joint Surgery, Brace for Extension of the Spine,July 1948, pages 784 and 785 relied upon. O;n file in Div. 55.

3. A SURGICAL BRACE COMPRISING A PUBIC PAD, BUTTOCKS PADS, PELVISENCIRCLING MEANS INCLUDING FRAME ELEMENTS FOR CONNECTING THE PUBIC ANDBUTTOCKS PADS, A THORACICLUMBAR PAD, SIDE PADS, MEANS INCLUDING FRAMEMEMBERS FOR CONNECTING RESPECTIVE SIDE PADS WITH THE THORACICLUMBAR PADAND WITH THE FRAME ELEMENTS AFORESAID, SAID CONNECTING MEANS INCLUDINGPINTLES PIVOTALLY CORRECTING RESPECTIVE FRAME ELEMENTS AND RESPECTIVEFRAME MEMBERS, AND MEANS FOR POSITIVELY FIXING THE ANGULAR POSITION OFEACH FRAME MEMBER RESPECTING THE FRAME ELEMENT WITH WHICH IT IS INPIVOTAL CONNECTION UPON THE RESPECTIVE PINTLE.